The Institutional Library

T Operative Treatment of Fractures. By Sir W. Arbuthnot Lane, Bart., M.S., F.R.C.S. Second Edition. (London : The Medical Publishing Company, Ltd. 1914. Pp. 184+iv. Price 10s.) Sir Arbuthnot Lane's views on the treatment of ractures come so sharply into conflict with what may be aDied the classical methods, that it is a great advantage 0 have them presented in a form accessible to the whole Jr?fession. Successive generations of students who have ad the advantage of following his teaching at the bedside Rurally become ready disciples. But outside this combatively limited area there are large opportunities for ^Isading energy, and hence the present volume is to be ,6artily welcomed. lor, let there be no mistake about !c. the issue is a highly practical one, and of the first ltl!1Portance. There is no concealment of the challenge in ^ch a statement as " I have described these badly united actures of the femur to show how useless and inefficient ?re the usual methods of treatment of these injuries even '^the hands of the most skilled and competent surgeons." Iially significant is the conclusion, based on a com^arison of fractures found in subjects in the dissecting with the teaching of recognised text-books : Though experience had taught me to regard the staters in anatomical and surgical works with very strong Jpicion, I was not prepared to find that the teaching the causation, pathology, and the treatment of fractures ^ the results of such treatment was often iabsolutely Se in almost every detail. It was evident that the disaced fragments of a broken bone were never, or hardly ev^r> restored to their normal position, and that the so'setting of fractures' was a myth." It is not


Second
Edition.
(London : The Medical Publishing Com- pany, Ltd. 1914.Pp. 184+iv.Price 10s.)Sir Arbuthnot Lane's views on the treatment of ractures come so sharply into conflict with what may be aDied the classical methods, that it is a great advantage 0 have them presented in a form accessible to the whole Jr?fession.Successive generations of students who have ad the advantage of following his teaching at the bedside Rurally become ready disciples.But outside this com- batively limited area there are large opportunities for ^Isading energy, and hence the present volume is to be ,6artily welcomed.lor, let there be no mistake about !c. the issue is a highly practical one, and of the first ltl!1Portance.There is no concealment of the challenge in ^ch a statement as " I have described these badly united actures of the femur to show how useless and inefficient ?re the usual methods of treatment of these injuries even '^the hands of the most skilled and competent surgeons."Iially significant is the conclusion, based on a com- ^arison of fractures found in subjects in the dissecting with the teaching of recognised text-books :   Though experience had taught me to regard the state- rs in anatomical and surgical works with very strong Jpicion, I was not prepared to find that the teaching the causation, pathology, and the treatment of fractures ^ the results of such treatment was often iabsolutely Se in almost every detail.It was evident that the disaced fragments of a broken bone were never, or hardly ev^r> restored to their normal position, and that the so- 'setting of fractures' was a myth." It is not rPrising that these conclusions when they were first ^Pressed raised a storm of opposition, and we fancy that ere are regions not a few in which the storm still con- ues.But " storms," from whatever quarter they blow, , * not settle disputed issues.The final decision rests , "? practice and experience and facts, and in Sir buthnot Lane's lectures all these are supplied in j ^dant measure.Whether they are conclusive is not l?r Us to decide.But they certainly cannot be ignored * any practitioner who undertakes the charge of , lents' with broken bones.To all such there can be no in saying that it is a duty to study Sir ^ outhnot Lane's teaching as this is set forth, with a ^ea^h of illustrations and much vigour of expression, in e Present volume.
Apart from its strictly practical P&ct, the book has much interest as a record of the Jesses of reasoning and observation by which the J'h r WaS conc^us^ons which he now advocates, j ese include, amongst other examinations, studies of the u?nces exerted by occupation and habit on joints, and th n^s arthritic disease may be advised to acquaint ^ eiHselves with views which they may possibly consider t?retical.But, in medicine at all events, we owe much ^ heretics, and we are sure Sir Arbuthnot Lane will ^ shrink from plain phrases.He himself never avoids v spade " for the sake of the " agricultural instru- 4 ; ' Altogether his lectures make enjoyable reading, ^ we cannot profess to be fully convinced this may ^ due to the hardness of our hearts.
Such, at least, are sure, is the explanation which Sir Arbuthnot Lane 1 Propose.
A Medical Novel.One Man's Way.A Novel.By Evelyn Dickinson.
(London : George Allen and Co., Limited.1914. Price 6s.) Both as a romance of more than average value, for holi- day reading and as a novel with a distinct medical interest this book may claim a short notice in the technical press.
The story itself is well told and is not encum- bered with semi-philosophic dissertations, but goes on with a directness which is enhanced by the character of ithe incidents in the stormy career of the medical hero.
This ohief person of the drama is a country practitioner in a quiet retreat in Devonshire; the invasion of an evil female causes disaster, but ultimately the doctor rises to great heights as an alienist in Queen Anne Street, W., and continues to meet with a few more passionate adventures before the book closes in some- what orthodox fashion.
The author has succeeded in telling a good story in a style quite comfortable to read, and there are enough exciting episodes to please the most exacting reader.
A Companion for Ward Work.Elements of Surgical Diagnosis.By Sir Alfred Pearce Gould, K.C.V.O., M.S., JF.R.C.S., and Eric Pearce Gould, M.Ch., F.R.C.S'.Fourth Edition. (London:   Cassell and Co., Ltd. 1914.Pp. 723+xiv.Price 10s.6d.net.) The first edition of this book was isued in 1884; it has been many times reprinted, and it now appears in a revised and enlarged fourth edition.Such a record of success seems to render superfluous the intervention of the reviewer, for the verdict of words must be weak when compared with the testimony of sales.Yet-there would seem to be some want of courtesy in a mere formal announcement, and this more particularly to a trusted and well-known friend.For, indeed, like many of our readers, we can recall the day when, the terror of examination being in our soul, Pearce Gould's " Surgical Diagnosis " was a very present help in time of trouble.Not that the book belongs to a class whose object is to produce a show of knowledge without its substance.Very far from it, indeed.Rather it is a companion for that diligent and earnest ward work which is the only sure preparation for soundness of method, just as sound- ness of method is the avenue to accurate diagnosis.All this and many other helpful maxims are urged in the opening chapters, where the students of to-day, as of yesterday, may imbibe those useful principles without which surgical practice is a theory of chance and of shallowness.The application of these principles in the body of the work involves an enormous mass of detail, and this is handled with skill and judgment, and is generally well adapted to the students' needs.On in- dividual points there may be some room for difference of opinion.Thus, while unilateral exaggeration of the knee- jerk is quoted as an aid in the localisation of an intra- cranial haemorrhage, no mention is made of the significance of a unilateral Babinski's sign; a sixth-nerve paralysis is described as the result of certain cerebral tumours, without any allusion to its feeble localising value; and the effect on the visual field of tumours involving the several parts of the visual tract is wrongly described.The visual result of a tumour exerting pressure on the optic chiasma is, as everyone knows, blindness in the temporal half of each visual field, and not, as stated on November 7, 1914- p. 375, "blindness in the temporal part of each retina"; a similar error occurs in the description of the effect of a lesion involving the visual tract in its course through the internal capsule.We may, perhaps, venture to question the phrase " blindness of the retina."The retina, or any part of it, may, of course, be described as ineffective in function, or, perhaps, as paralysed ; but blindness is a quality, not of the retina, but of the visual field; and we think it is a failure to appreciate this difference that has led to the confusion of statement to which we now direct attention.In any event such blunders are very bewildering for the unfortunate student.These criti- cisms, it is true, concern subjects somewhat outside the main surgical stream, but they certainly suggest the need for a more careful revision in such directions.So far as its chief purpose is concerned the value of the book is attested beyond challenge.
The Sanatorium as a School.
The Tuberculosis Handbook.
By A. H. G. Burton, M.D. (Lond.),D.P.H. (The Scientific Press, Limited. Price 2s.6d.net.) This little handbook is intended for the use of " health visitors and nurses, all social workers, heads of families, and others."It sets forth very simply such of the principal facts relating to tuberculosis as should be known by all engaged in public health work.
The methods of infection are explained, and the recent report of the Royal College of Physicians on the infectivity of the disease is quoted in full.The danger arising from the cough of a consumptive patient is pointed out, but it is a matter of regret that the author does not emphasise the extreme importance of teaching patients invariably to hold paper handkerchiefs over the mouth during the act, whether expectoration is anticipated or not.
Yet experience shows the great difficulty there is in getting patients to carry out this simple but all-important precaution.Treat- ment is dealt with under three heads : (1) Tuberculin; (2) Sanatorium; (3) Pneumo-thorax and other modes of treatment.
These are simply and lucidly explained, but some may cavil at the precedence accorded to tuberculin.This is doubtless explained by the fact that the author is connected with dispensary work in which the results of tuberculin therapy appear to be rather more favour- able than those obtained in residential institutions.
The satisfactory results that may be expected from a previous stay in a sanatorium, with all its educational advantages, are pointed out.In this connection it is difficult to understand why Dr. F. J. Smith, at the recent annual meeting of the British Medical Association, should deprecate the instruction given to sanatorium patients to take their own temperatures on leaving.The sanatorium is the proper place to teach patients to read a thermometer, and to emphasise the importance of the temperature in regulating rest and exercise.Without a temperature chart domiciliary and dispensary treatment cannot be scientifically carried out.In addition to pulmonary tuberculosis, the other forms of the disease with their appropriate treatment are briefly indicated, and a chapter is devoted to a description of the work of the tuberculosis dispensary and a nurse's duties in connec- tion therewith.Recent legislation dealing with tuber- culosis and the meaning of the Sanatorium Benefit clauses of the National Insurance Act are briefly explained.This little volume will be found extremely useful to all, whether intending to enter tuberculosis service or not, and should be read by all women engaged in district nursing, whose many duties will include attend- ance on patients receiving domiciliary treatment.
A Guide to Medical Electricity.

Practical
Medical Electricity.
By Alfred Norman, M.D. (London : The Scientific PreSS' Limited.1914.Pp. 226-f-viii.Price 5s.net.) The ambition of Dr. Norman's book is to act aS a link between works on medical electricity in the ordinal sense of this term and books written for the technic3' student.It keeps clearly in view the needs of the praC' titioner who desires to utilise the diagnostic and ther?' peutic values of electricity, while recognising that these values will not be obtained unless the scientific doctrioeS on which they are based are fully understood.We say at once that, in our opinion, this programme ha5 been very largely realised.Special pains have evident!) been taken to obtain lucidity, for which the author de" serves an ungrudging word of gratitude and recognition Various forms of apparatus are illustrated, and diagraIljS are introduced to aid the descriptions given in the te3C*' Of the applications of electricity for medical purp?seS' special attention is given to the production and uses 0 the z-rays.This section throughout has the authority of one who speaks with first-hand knowledge, and has personally met?and overcome?thedifficulties of method.
Indeed, we know of no book which meets s? satisfactorily the wants of a practitioner who desires t? equip himself in this branch of practice.It will 9 surprise to some to read that good work may be dot!e, here with comparatively simple apparatus, provided ony the user thoroughly understands his tools.The catalog1"2' of the instrument makers seem to contradict this, blJ personally we place more confidence in Dr. Norma"* experience.His book is a very helpful one, and oug11, to have a large success.It will assuredly be welcooa?by the thousands of our readers who read the chapters as they first appeared in the pages of The Hospital.
Pasteur and After Pasteur.
Bv Stephen Pag?1' F.R.C.S. (Adam and Charles Black.Medical His^ Manual Series.Price 3s.6d.net.) The difficult art of omission is most skilfully PrfC, tised in this well-written and compact volume, sets a standard for the series which it begins that publishers will not find easy to maintain.Subject a^ author, in the case of Pasteur and Mr. Stephen Pa? I are, as friends and enemies alike will admit, sfljlt perfectly to each other.The result is a lucid, succi11 ^ summary of Pasteur's work from his early mathematic3^ studies with " the pupil-teacher's board and lodging a" twelve pounds a year at the College of Besangon," ?way of the Ecole Normale, to the study of crystal!1" forms, and then ferments.At last his researches into t diseases of wines, and of infectious diseases in ani?a ' grew out of one another till, as by organic developing the germ-theory of disease, and modern pathology an bacteriology with their immense reactions not merely medicine, but in civilisation, as in Panama, evolved new science of preventive medicine in all its Protea forms.
It is wonderful to have packed so much, clearly, into 150 pages, and the reader will regret on J that the series was not of larger scope.Many inter?s^ ing volumes are to follow in it, and as the announce ^ list is capital as far as it goes, may we suggest that least three volumes should be added to it ??one ?0 Jenner and eighteenth-century inoculation, one on Han" mann, and one, not to be overlooked, on the growth of p open-air treatment as first taught by George Boding^ and early pioneers.Were it not an obvious cliche, -c should describe Mr. Paget's capital book as a scient1^ romance, but lest the enemies of the Research Defc" Society should seize on the misinterpretation to which \ phrase is liable, we will call it merely a good worl example of what a manual of medical history should